True Reproductive Health

Reproductive health is the subject of numerous international conferences, United Nations meetings, agency reports, and NGO papers, yet the meaning of the term can vary widely”and very consequentially. Clarity about reproductive health is increasingly necessary as United Nations Member States seek to honor the Millennium Development Goals, one component of which is achieving universal access to reproductive health. This requires clarity about exactly what reproductive health is.

A newly issued World Youth Alliance white paper that I authored seeks to set the record straight. It begins by looking at the Programme of Action, the consensus document resulting from the 1994 International Conference on Population and Development, the first United Nations conference to define reproductive health. Although not legally binding, the Programme of Actions definitions of terms such as reproductive health, reproductive health care, and reproductive health services are instructive because the document is a declaration of political will, meaning that States who approved it are committed to carrying out its objectives; further, it is the most cited document on reproductive health in global health policy discussions. Delegates at the ICPD consciously did not include abortion as a component of reproductive health, expressly reserving changes in abortion policy to individual States and local governments. Follow-up commissions to the ICPD, in addition to the Fourth World Conference on Women in Beijing in 1995 and its own follow-up commissions, have not elaborated on the definition of reproductive health provided in the Programme of Action, and States have continued to express their understanding that abortion is not a part of reproductive health.

The white paper objectively investigates international law, examining what human rights treaties actually say”and do not say”on the topic. Only one treaty even mentions reproductive health, and none establishes a right to reproductive health. The paper further explains that treaty-monitoring bodies, such as the Human Rights Committee, do not have the authority to create new rights not enumerated in international treaties. Nor do they have the authority to bind States with their concluding observations.

Materials from various UN agencies and NGOs like the Center for Reproductive Rights and the International Planned Parenthood Federation often assert without basis that abortion is the primary aspect of reproductive health and that there is an international right to reproductive health. But promoters of abortion as a necessary component of reproductive health do not acknowledge the actual definition of reproductive health agreed on in Cairo in 1994, even though they are ready and willing to cite the Programme of Actions call for an international right to reproductive health. Those who identify an international right to abortion do not quote actual provisions of international treaties but instead make tenuous connections between right-to-life treaty provisions and abortion; after all, safe abortion guarantees the right to life of all women. They cite treaty-monitoring bodies as if their word were law. Unfortunately, the constant repetition that abortion is necessary for reproductive health has had some effect, leading some to give soft law more weight than it is due.

These distortions demonstrate the need for white papers in global health policy discussions. A white paper simultaneously educates readers and advocates for a particular position. Misinformation and disinformation are rampant in global health discussions, and white papers provide an opportunity for clarification. Developing countries are often the intended audience, given that they have limited resources in policy battles. A white paper gives them a straightforward analysis of the law, exposing the gaps left by other organizations and agencies.

The white paper thus becomes an important tool for developing countries in maintaining their ground at the United Nations and in other international negotiations. These countries are sometimes threatened by their more powerful counterparts”including the United States”with the withholding of foreign aid if they do not implement new policies and programs that match the agenda of the Western world. If they are equipped at the negotiating table with accurate information about the law, they are better equipped to maintain their positions.

Of course, it is possible for white papers to mislead. Proponents of non-existent human rights often make assertions without citing any sources, an omission that should alert the reader to the likely falsity of the claim. A good white paper is well sourced, and readers must be discriminating about the authority of the sources, though unfortunately, certain organizations are so visible that people think whatever they say must be true. The World Youth Alliances reproductive health white paper is helpful in this regard, identifying where organizations and agencies have made unfounded claims about international law.

White papers are needed to clarify confusion about some of the most salient topics in global health policy discussions, including family planning, maternal health, and HIV/AIDS. If countries are educated about where international law stands on these issues and are provided with evidenced-based information, they will be able to develop their own”and therefore appropriate and more likely effective”health policies without bowing to pressure from the bullies of international policy.

Meghan Grizzle is Research and Policy Specialist at the World Youth Alliance. She graduated from Harvard College in 2007 with a Bachelors and a Masters in Linguistics and from Harvard Law School in 2011. RESOURCES